IndividualActive
Fred Lucas, DDS
NPI 1619988771 · Periodontics · Skokie, IL
Provider details
- NPI number
- 1619988771
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 019023343 (IL)
Specialties & taxonomies
Dental Providers
Practice location
9933 Lawler Ave
Skokie, IL 60077-3703
Phone: (847) 675-4867
Approximate (ZIP-level) locationGet directions
Mailing address
701 Thompson Blvd
Buffalo Grove, IL 60089-1013
Registry dates
- Enumerated
- 2006-08-11
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.